NPI | 1639597735 |
---|---|
Former Name | KAIA MARIE WAKAMIYA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 016265) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 21740) |
Enumeration Date | 2014-04-04 |
Last Update Date | 2023-01-31 |